A case of chronic hemorrhagic radiation sigmoiditis treated by steroid enema

A 86-year-old woman was admitted to our hospital with hematochezia. Colonoscopy was performed, and showed multiple telangiectasia and congestive bleeding on sigmoid colon. She has a medical history of uteri cancer and treated with radiation therapy. Thus, she was diagnosed radiation sigmoiditis. Argon plasma coagulation (APC) was performed, but because of its wide range of lesion, sufficient therapeutic effect could not obtained. The steroid suppository and enema are commonly used to treat proctitis and sigmoiditis, and which is considered to be effective to improve edema and inflammation of intestinal tract. Because of it, we started the steroid enema. After 10 days of treatment, colonoscopy was performed, and it shows the mucosal healing of sigmoid colon. This case suggests that combination of APC and the steroid enema are useful to the treatment of chronic hemorrhagic radiation sigmoiditis.